Patient Discussion Guide: UNDERSTANDING FIBROMYALGIA HOW TO MANAGE IT&

Patient Discussion Guide: UNDERSTANDING FIBROMYALGIA HOW TO MANAGE IT&

FM OVERVIEW 2 What is Fibromyalgia? Reinforce that Fibromyalgia (FM) is a chronic widespread pain condition 1,2 Reassure the patient that millions of people have FM, so he or she is not alone 3 Point out that FM is a chronic condition, but improvement through treatment is achievable over time 4 Fibromyalgia is characterized by chronic widespread pain and tenderness, thought to be the results of overactive nerves 1,2 over 5 million Americans are estimated to have Fibromyalgia 3 Fibromyalgia is more common in women, but it also occurs in men 2

FM Symptoms 3 What are the symptoms of Fibromyalgia? after reviewing the symptoms of FM, explain to the patient that: evaluation of symptoms is an important part of developing an individualized treatment plan and setting goals 5 tracking progress will be based on the patient s individual goals 4 the main goal of the treatment plan is improvement of symptoms and daily functioning 6 the core symptom of Fibromyalgia is chronic widespread pain, defined as all-over pain lasting longer than 3 months 1 Different people feel pain in different ways. Fibromyalgia pain may be felt as 1 : Deep muscle pain and soreness Morning stiffness Tenderness Radiating pain Flu-like aching Shooting pain Fibromyalgia sufferers can also experience other symptoms, which may include 1,7 : Problems sleeping Fatigue Difficulty thinking clearly, Depression and/or anxiety also known as Fibro fog

FM Causes 4 What causes Fibromyalgia? explain in more detail the connection between overactive nerves and the chronic widespread pain of FM explain the possible risk factors of FM: family history, physical and emotional disorders, infections, and autoimmune diseases 7 Overactive Nerves Many researchers believe that the chronic pain of Fibromyalgia may be a result of overactive nerves in the central nervous system. This can cause a more intense response to pain 7 overactive nerves may lead to greater sensitivity to pain. It s almost as if the volume control for pain is turned up 7 For example, even things that are not normally painful, such as a handshake, a hug, or tight-fitting clothing, can be painful 6 it s likely that a number of factors may trigger and contribute to Fibromyalgia. These include 7 : Family history Physical and emotional disorders Infection Autoimmune diseases

FM Treatment Plan 5 What would my Fibromyalgia treatment plan include? Point out that FM is a chronic condition, but improvement is achievable over time 4,8 explain that no single treatment works for every patient, so the personalized treatment plan may include a combination of approaches 4,9 emphasize that it is important for the patient to take an active role in managing the condition. Also mention that adherence is crucial to achieving treatment plan goals 6,9 a comprehensive treatment plan that is personalized for you may include: Education 10 Prescription medication: can help minimize Fibromyalgia symptoms and improve daily function 11 alternative therapies: physical activity, cognitive-behavioral therapy, improved sleep routine, stress management, and an eating plan 12-14 Follow-up and tracking 15 Fibromyalgia cannot be cured. However, it can be effectively managed with a comprehensive treatment plan 8 the main goal of treatment is improvement of symptoms and daily function over time 6

FM Support Team 6 Who is on my support team? explain what other medical experts, if needed, will be helping to treat the patient and why 6,7 Reiterate that the patient plays a key role in managing his or her FM 9 ask the patient about whether family and friends are helping, or can help. Who can help and how? 6,7 Direct the patient to resources that can help him or her find a support group 1,6 Your primary care doctor (and other specialists, if needed): the better the teamwork, the better the treatment plan. Ask questions because you play an important role in treatment success. Share information about how you re feeling and about your progress 4,9 Your family and friends: They want to help. Give them specific ways to assist you 6,7 A support group: sometimes it s easier to talk to people who are living with the same condition. Ask for resources to find a group in your area or start your own 1,6

Conclusion 7 What can I do to help make management of my Fibromyalgia a success? Conclude your discussion by emphasizing that: although FM is a chronic condition and cannot be cured, it can be effectively managed 4 the main goal of a treatment plan is improvement of symptoms and daily functioning over time 4 no single treatment works for every patient, so the personalized treatment plan may include a combination of approaches 4,9 self-management of the plan is crucial for its success, and requires the patient to be actively involved 6,9 Follow every part of your treatment plan, including taking your medication as prescribed 10,11 Keep scheduled appointments so you can track your success 15 share information about how you re feeling and about treatment progress with your Fibromyalgia support team 4,15

REFERENCES 8 1. The Johns Hopkins Library. Understanding & Managing Fibromyalgia Syndrome. New York, NY: University Health Publishing-MediZine LLC. 2009. 2. Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum. 1995;38(1):19-28. 3. lawrence RC, Felson DT, Helmick CG, et al, for the National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008;58(1):26-35. 4. Bayliss EA, Bosworth HB, Noel PH, Wolff JL, Damush TM, McIver L. Supporting self-management for patients with complex medical needs: recommendations of a working group. Chronic Illn. 2007;3:167-175. 5. Arnold LM. Biology and therapy of fibromyalgia: new therapies in fibromyalgia. Arthritis Res Ther. 2006;8(4):212. doi:10.1186/ar1971. 6. Data on file. Core principles of fibromyalgia management: a chronic care framework and practical approaches for implementation in primary care. 1st ed. Pfizer Inc, New York, NY. March 16, 2011. Draft. 7. Clauw DJ, McCarberg B. The FibroCollaborative Roadmap for Change: A Call to Action for Fibromyalgia. New York, NY: Pfizer Inc; 2010. www.fibrocenter.com/roadmap. 8. Paiva ES, Jones KD. Rational treatment for fibromyalgia for a solo practitioner. Best Pract Res Clin Rheum. 2010;24:341-352. 9. Stahl SM. Stahl s Illustrated Chronic Pain and Fibromyalgia. New York, NY: Cambridge University Press; 2009. 10. Goldenberg DL. Pharmacologic management. In: Clinical Management of Fibromyalgia. West Islip, NY: Professional Communications, Inc; 2009:69-95. 11. carville SF, Arendt-Nielsen S, Bliddal H, et al. EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis. 2008;67:536-541. doi:10.1136/ard.2007.071522. 12. Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L. An internet survey of 2,596 people with fibromyalgia. BMC Musculoskelet Disord. 2007;8:27. doi:10.1186/1471-2474-8-27. 13. Williams DA, Marshak ML. Motivating behavioral change in fibromyalgia. In: McCarberg BH, Clauw DJ, eds. Fibromyalgia. New York, NY. Informa Healthcare; 2009:136-151. 14. National Institutes of Arthritis and Musculoskeletal and Skin Diseases Web site. www.niams.nih.gov/health_info/fibromyalgia/default.asp. Accessed March 24, 2011. 15. McCarberg BH. for the primary care provider. In: McCarberg BH, Clauw DJ, eds. Fibromyalgia. New York, NY: Informa Healthcare; 2009:152-158. PBP01851A/PBP429800-01 2011 Pfizer Inc. All rights reserved. December 2011